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A patient presents with a sensation of a foreign body stuck in the throat, difficulty swallowing, and odynophagia. Flexible laryngoscopy reveals a submucosal mass arising from the posterior pharyngeal wall. Which of the following conditions is most likely responsible for this presentation?
- A. Zenker's diverticulum
- B. Laryngopharyngeal reflux (LPR)
- C. Hypopharyngeal carcinoma
- D. Tonsillar hypertrophy
Correct Answer: A
Rationale: Zenker's diverticulum is a condition in which there is a pouch or sac that forms at the posterior pharyngeal wall above the upper esophageal sphincter. It can present with symptoms such as sensation of a foreign body stuck in the throat, difficulty swallowing (dysphagia), and odynophagia (painful swallowing). Flexible laryngoscopy can reveal a submucosal mass arising from the posterior pharyngeal wall, which is characteristic of Zenker's diverticulum.
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A patient with a severe fungal infection demonstrates impaired neutrophil function. Which of the following cellular processes is most likely to be affected in this patient?
- A. Phagocytosis
- B. Antibody production
- C. Cytokine secretion
- D. Mast cell degranulation
Correct Answer: A
Rationale: Neutrophils are a type of white blood cell that play a crucial role in immune defense against pathogens, particularly in phagocytosis - the process by which they engulf and destroy invading microorganisms. In a severe fungal infection, impaired neutrophil function would most likely affect their ability to effectively perform phagocytosis, leading to a compromised immune response against the fungal pathogen. This would result in increased susceptibility to the infection and potentially severe outcomes for the patient. Antibody production, cytokine secretion, and mast cell degranulation are important components of the immune response, but neutrophils are primarily responsible for phagocytosis in the innate immune system.
Which imaging modality is most commonly used to diagnose fractures of the long bones, such as the femur or tibia?
- A. X-ray
- B. Magnetic resonance imaging (MRI)
- C. Computed tomography (CT) scan
- D. Ultrasound
Correct Answer: A
Rationale: X-ray is the most commonly used imaging modality to diagnose fractures of the long bones, such as the femur or tibia. X-rays are readily available, fast, cost-effective, and provide detailed images of the bone structures. Fractures appear as breaks or discontinuities in the bone on X-ray images, making it an excellent tool for diagnosing bone fractures. In many cases, X-rays are sufficient to confirm the presence, location, and type of fracture, allowing for appropriate treatment planning. Other imaging modalities like MRI and CT scans may be used for further evaluation in complex cases, but X-ray remains the initial and primary choice for diagnosing long bone fractures.
In CO-PAR, which is the MOST important role of the public health nurse?
- A. Caregiver
- B. Financer
- C. Expert
- D. Adviser
Correct Answer: C
Rationale: In the context of CO-PAR (Community Organizing Participatory Action Research), the most important role of the public health nurse is being an expert. Public health nurses are expected to have specialized knowledge and skills in the field of public health, allowing them to provide evidence-based guidance and interventions to support community health initiatives. As an expert, the public health nurse can assess community needs, develop appropriate interventions, educate community members on health promotion and disease prevention, and evaluate the effectiveness of implemented programs. By utilizing their expertise, public health nurses can effectively contribute to improving the health outcomes and well-being of the community they serve.
Nurse Nilda immediately responds to any cry from her pediatric patients because it is, which of the following reasons?
- A. to attend to her patients who cannot communicate verbally
- B. to check if the child is hungry or wet
- C. to lessen the noise overload in the Unit
- D. a powerful influence over that individual's interactions with others for the remainder of his/her 1ife
Correct Answer: A
Rationale: Nurse Nilda immediately responds to any cry from her pediatric patients to attend to her patients who cannot communicate verbally. Crying is one of the few ways infants and young children communicate their needs and discomforts. By responding promptly to their cries, Nurse Nilda can assess and address potential issues such as hunger, pain, discomfort, or other needs that the child may have. This enhances the quality of care provided and helps in comforting and soothing the child, ultimately promoting their well-being and building trust between the nurse and the patient.
A patient presents with chest pain, dyspnea, and signs of hypotension. An electrocardiogram (ECG) shows ST- segment elevation in the inferior leads. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Aortic dissection
Correct Answer: C
Rationale: Chest pain, dyspnea, hypotension, and ST-segment elevation on an ECG in the inferior leads are classic signs of an acute myocardial infarction (MI). An acute MI occurs when there is a sudden blockage of blood flow to a part of the heart muscle, leading to tissue damage. This causes symptoms such as chest pain due to ischemia, dyspnea due to heart failure, and hypotension due to poor cardiac output. The ST-segment elevation seen on the ECG is indicative of significant myocardial injury. Prompt diagnosis and management are crucial in acute MI to prevent further complications and to minimize damage to the heart muscle. It is important to differentiate an acute MI from stable or unstable angina or other cardiovascular disorders, as the management and prognosis vary significantly.